Spontaneous Pneumomediastinum, Pneumopericardium and Pneumorrhachis as potential complications of 2009 pandemic influenza A (H1N1) virus infection in healthy children

• Authors: Filomena Pierri , Antonio Chiaretti , Giuseppe Barone , Donato Rigante , Piero Valentini , Claudia Fantacci , Danilo Buonsenso , Riccardo Riccardi
• Languages of publication: EN

Abstracts

EN

We report on two cases of spontaneous pneumomediastinum and pneumopericardium, in one case associated with pneumorrhachis, occurring in two children suffering from the novel influenza H1N1 virus infection. At the admission both children presented with fever, violent dry cough, dyspnea and tachypnea. Radiological studies showed sizeable pneumomediastinum and pneumopericardium in both patients. One of the patients also a pneumorrachis. Children were initially treated by intravenous broad-spectrum antibiotics, antipyretics and a cough sedative. Oral Oseltamivir (60 mg twice daily for 5 days) was administered after the diagnosis of influenza A (H1N1) virus infection. Patients’ clinical condition quickly improved and children were discharged with a partial resolution of their radiological findings. Although these conditions are usually self-limiting and without respiratory or systemic consequences, their prompt recognition in children with H1N1 influenza virus infection is essential to establish fast and adequate therapy mainly related to the control of cough and the commencement of antiviral treatment.

Keywords

EN

Influenza virus infection; Pneumomediastinum; Pneumopericardium; Pneumorrhachis

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2011
• Volume: 6
• Issue: 4
• Pages: 386-389

Dates

published

1 - 8 - 2011

online

1 - 6 - 2011

Contributors

author

Filomena Pierri

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Antonio Chiaretti

• Pediatric Intensive Care Unit — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Giuseppe Barone

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Donato Rigante

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Piero Valentini

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Claudia Fantacci

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Danilo Buonsenso

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

author

Riccardo Riccardi

• Department of Pediatrics — Gemelli Hospital, Catholic University Medical School of Rome, 00168, Rome, Italy

References

• [1] Garten RJ, Davis CT, Russell CA, et al., Antigenic and genetic characteristics of swine-origin 2009 A (H1N1) influenza viruses circulating in humans. Science 2009; 325, 197–201 http://dx.doi.org/10.1126/science.1176225[Crossref][WoS]
• [2] Hasegawa M, Hashimoto K, Morozumi M et al., Spontaneous pneumomediastinum complicating pneumonia in children infected with 2009 pandemic influenza A (H1N1) v virus. Clin Microbiol Infect 2010;16, 195–199 http://dx.doi.org/10.1111/j.1469-0691.2009.03086.x[WoS][Crossref]
• [3] Thompson WW, Shay DK, Weintraub E, et al., Influenza-associated hospitalizations in the United States. JAMA 2004; 292, 1333–1340 http://dx.doi.org/10.1001/jama.292.11.1333[Crossref]
• [4] Centers for Disease Control. Hospitalized patients with novel influenza A (H1N1) virus infection-California, April–May 2009. MMWR Morb Mortal Wkly Rep 2009;58, 536–554
• [5] Ozdemir H, Kendirli T, Dinçaslan HU, et al. Spontaneous pneumomediastinum in a child due to 2009 pandemic influenza A (H1N1) virus. Turk J Pediatr 2010;52:648–651
• [6] Udupa S, Hameed T, Kovesi T. Pneumomediastinum and subcutaneous emphysema associated with pandemic (H1N1) influenza in three children. CMAJ 2011;183:220–222
• [7] Caceres M, Ali SZ, Braud R, et al., Spontaneous pneumomediastinum: a comparative study and review of the literature. Ann Thorac Surg 2008;86, 962–963 http://dx.doi.org/10.1016/j.athoracsur.2008.04.067[Crossref][WoS]
• [8] Chalumeau M, Le Clainche L, Sayeg N, et al., Spontaneous pneumomediastinum in children. Pediatr Pulmonol 2001;31:67–75 http://dx.doi.org/10.1002/1099-0496(200101)31:1<67::AID-PPUL1009>3.0.CO;2-J[Crossref]
• [9] Romero J, Izquierdo Hidalgo J, Macià Botejara E, et al., Spontaneous pneumopericardium in a patient with community-aquired pneumonia. Rev Esp Cardiol 2005, 58, 227–229 http://dx.doi.org/10.1157/13071898[Crossref]
• [10] Oertel MF, Korinth MC, Reinges MH, et al. Pathogenesis, diagnosis and management of pneumorrhachis. Eur Spine J 2006;15, 636–643 http://dx.doi.org/10.1007/s00586-006-0160-6[Crossref]
• [11] Aribas OK, Gormus N, Aydogdu Kiresi D. Epidural emphysema associated with primary spontaneous pneumothorax. Eur J Cardiothorac Surg 2001;20, 645–646 http://dx.doi.org/10.1016/S1010-7940(01)00851-X[Crossref]
• [12] Chiba Y, Kakuta H. Massive subcutaneous emphysema, pneumomediastinum, and spinal epidural emphysema as complications of violent coughing: a case report. Auris Nasus Larynx 1995;22, 205–208 [PubMed][Crossref]
• [13] Tutor JD, Montgomery VL, Eid NS. A case of influenza virus bronchiolitis complicated by pneumomediastinum and subcutaneous emphysema. Pediatr Pulmonol 1995;19, 393–395. http://dx.doi.org/10.1002/ppul.1950190614[Crossref]
• [14] Shimizu T, Mochizuki H, Morikawa A. Effect of influenza A virus infection on acid-induced cough response in children with asthma. Eur Respir J 1997;10, 71–74 http://dx.doi.org/10.1183/09031936.97.10010071[Crossref]

Identifiers

DOI

10.2478/s11536-011-0036-y